Individual
DR. TIMOTHY H. MCGILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
279 W 80TH PL, MERRILLVILLE, IN 46410-5491
(219) 738-2180
(219) 738-2847
Mailing address
9795 CROSSPOINT BLVD, STE 100, INDIANAPOLIS, IN 46256-3354
(317) 254-6480
(317) 259-8609
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001839B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201037950A
—
IN
Enumeration date
02/22/2007
Last updated
09/09/2014
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